Evolution of behavioral and psychological symptoms of dementia in the logopenic variant of primary progressive aphasia
Bibliographic record
Abstract
Abstract Background The logopenic variant of primary progressive aphasia (lvPPA) is known to be associated with behavioral and psychological symptoms of dementia (BPSD) such as depression and apathy. However, few data are available regarding the evolution of BPSD, particularly in advanced stages and end of life, which is often of great concern for patients and families. Method We performed a retrospective chart review in a cohort including 42 deceased patients with a diagnosis of lvPPA. Symptoms of BPSD were assessed from disease onset to death by three experienced raters and, when possible, interviews were performed with proxies of patients to complete the missing data. Result Depression and anxiety were mostly prevalent at the early stages but decreased over time. In particular, at one‐year after first visit, 36% of the patients were affected by anxiety symptoms and 19% were suffering from depressive symptoms. Apathy increased with the follow‐up with a peak at 5 years from the first clinical visit (46% of the patients). Other BPSD such as rituals, hyperorality, or agitation were less prevalent throughout the disease. Nevertheless, patients frequently presented with dishinibition during the follow‐up (between 20‐36% of the patients during the 5 years following the first visit). Antidepressants were used in around 20‐28% of the patients from first visit to later stages, followed by anxiolytics (3‐22%). Antipsychotics were mostly used in the advanced stages. At the first visit, 42% of the patients were treated with acetylcholinesterase inhibitors. During the follow up, this rate fluctuated between 40‐64%. Conclusion Affective symptoms were most prevalent in prodromal and early stages, whereas in the advanced stages, lvPPA was mostly characterized by apathy. Dishinibition was also frequent during the follow‐up. These findings could support a psychiatric assessment in the early stages, since depression and anxiety are known to respond well to psychotropic treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".